Doctor: Focus on reducing prescription of opioid drugs

Groton library launches series on different aspects of drug problem

Groton — Dr. Michael Saxe showed an audience at Groton Public Library Monday a picture of two people frantically mopping the floor while a faucet ran full blast in an overflowing sink in the background.

That is what the public is doing in its efforts to control the opioid epidemic, said Saxe, chairman emeritus of the Middlesex Hospital Emergency Department. While treatment for those addicted is important, more public attention must focus on the prescription drugs by doctors, he said.

Saxe spoke before an audience of 20 to kick off a series at the library on the opioid crisis. The series includes a film screening of “Requiem for a Dream” at 6:30 p.m. on Thursday, a panel discussion at 7 p.m. on Feb. 15 moderated by Ken Edwards of Community Speaks Out, and a training session for the public at 6 p.m. on Feb. 22 about how to administer Narcan, a drug used to counteract the effects of heroin.

Saxe used the sink analogy to say there isn’t enough attention being devoted to the early phase of addiction, where someone has been taking opioids for less than a week, or the middle phase, where someone has been taking the drugs for one week to three months, Saxe said.

“This is where the future opioid addicts are being made, even today,” he said. Then he showed the photo. “They are working furiously with mops trying to mop up the water on the floor. But they’re not addressing the cause of the problem. They’re not turning off the faucet. Until they turn off the faucet, they’re going to be mopping up the floor forever.”

About 75 to 80 percent of new heroin addicts begin with legally prescribed opioids, and almost 70 percent are getting the pills from a friend or relatives leftover medicine, he said.

“So every other opioid prescription has some risk of leading to dependency, addition and overdoses and deaths,” he said. What’s needed is more public education, a decrease in prescription of opioid drugs to the level prescribed in 1995, an 80 percent reduction from current levels.

Saxe gave a brief history of the use of opioids, including the 1996 decision by the U.S. Food and Drug Administration to approve the use of oxycontin for non-cancer pain. Purdue Phara, the making of the drug, marketed it as addictive in less than 1 percent of the population, and focused on the undertreatment of pain when addressing physicians, Saxe said.

The Joint Commission, a nonprofit organization that accredits health care organizations and programs, also developed a 1-10 pain scale in 2000 and required hospitals to treat pain rated at more than zero, Saxe said. The combination of false education about a pain medication and a decision by the major regulatory agency requiring treatment of all pain contributed to the rise in prescription of opioids, he said.